How much rates vary
Facilitymedian $35 · 10th to 90th $25 to $56Professionalmedian $32 · 10th to 90th $25 to $56
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier None (both parts) Typical Low $24.55 Median $24.55 Typical High $34.67 | Professional | None (both parts) | $24.55 | $24.55 | $34.67 |
BCBS South Carolina Setting Facility Modifier None Typical Low $51.29 Median $56.23 Typical High $56.23 | Facility | None | $51.29 | $56.23 | $56.23 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $32.36 Median $45.71 Typical High $56.23 | Professional | None (both parts) | $32.36 | $45.71 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None (both parts) Typical Low $25.12 Median $25.12 Typical High $34.67 | Professional | None (both parts) | $25.12 | $25.12 | $34.67 |
Medcost Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $38.02 | Professional | None | $37.15 | $37.15 | $38.02 |
Medcost Setting Facility Modifier None Typical Low $17.78 Median $26.92 Typical High $67.61 | Facility | None | $17.78 | $26.92 | $67.61 |
Medcost Setting Professional Modifier None (both parts) Typical Low $30.90 Median $39.81 Typical High $74.13 | Professional | None (both parts) | $30.90 | $39.81 | $74.13 |
Molina Setting Professional Modifier None (both parts) Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None (both parts) | $37.15 | $37.15 | $37.15 |
United Setting Facility Modifier None Typical Low $27.54 Median $29.51 Typical High $75.86 | Facility | None | $27.54 | $29.51 | $75.86 |
United Setting Professional Modifier None (both parts) Typical Low $21.38 Median $27.54 Typical High $41.69 | Professional | None (both parts) | $21.38 | $27.54 | $41.69 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $12.30 Typical High $17.38 | Professional | 52 · Reduced service | $12.30 | $12.30 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $7.08 | Professional | 53 · Discontinued | $4.90 | $4.90 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $5.25 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $3.47 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $3.47 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $15.85 Median $16.60 Typical High $38.90 | Professional | 26 · Professional part | $15.85 | $16.60 | $38.90 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $46.77 Median $60.26 Typical High $147.91 | Professional | 50 · Both sides | $46.77 | $60.26 | $147.91 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $15.49 Median $19.95 Typical High $48.98 | Professional | 51 · Multiple procedures | $15.49 | $19.95 | $48.98 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.17 Median $7.94 Typical High $19.50 | Professional | 80 · Assistant surgeon | $6.17 | $7.94 | $19.50 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.37 Median $5.62 Typical High $13.80 | Professional | 81 · Minimal assistant surgeon | $4.37 | $5.62 | $13.80 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.37 Median $5.62 Typical High $13.80 | Professional | 82 · Assistant surgeon, no resident | $4.37 | $5.62 | $13.80 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.37 Median $5.62 Typical High $13.80 | Professional | AS · PA/NP assist | $4.37 | $5.62 | $13.80 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $23.99 Median $25.12 Typical High $58.88 | Professional | TC · Technical part | $23.99 | $25.12 | $58.88 |
Where South Carolina sits
The same service costs 2.5 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
South Carolina· 44th of 51
$32.36
HI $64.57DE $25.70
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.